1 - (SYM 43) Co-creating the Prevention Program for Adolescent Relationship and Emotional Development (PREPARED): A Community Based Participatory Study in Rural Kenya

Background: Community based participatory research (CBPR) principles emphasize the necessary involvement of community members as equitable partners in each phase of research. This study aimed to co-create a novel intervention to promote mental health and prevent intimate partner violence (IPV) among adolescents in rural Western Kenya, a setting with limited mental health resources and heightened rates of IPV.

Methods: We used a CBPR approach to intervention co-design following the transcreation framework for community-engaged behavioral interventions to reduce health disparities. In step 1, we clarified key challenges facing adolescents through two community listening meetings. 

Meetings also informed the establishment of a community advisory board (CAB). In step 2, the established CAB worked with the research team to analyze formative qualitative data on adolescent mental health and IPV and assess whether data appropriately and adequately reflected community needs. In step 3, three intervention development workshops were held to match evidence-based practices with CAB input on cultural and contextual factors affecting intervention design and sustainability. Finally, step 4 involved developing an intervention prototype through a collaborative, iterative feedback process with CAB members. 

Results: Themes from community listening meetings clarified the overlapping drivers of adolescent mental health challenges and IPV. Our assembled CAB consisted of ten government, health, education, and business sector representatives and two youth members. Findings from CAB meetings confirmed formative data appropriately represented the community culture and needs. The co-creation process resulted in a 6-session intervention designed to promote the well-being and prevent IPV among 14-17 year olds. The first two sessions directly target mental health through emotion identification and behavioral coping; the third and fourth sessions focus on healthy relationship development by promoting gender equity and couples’ communication; and the last sessions combine mental health and relationship-related components to foster conflict resolution and problem solving.

Conclusion: Community engagement from the start of intervention development initiates the co-creation process and can address needs in ways that are relevant and acceptable to the community at the outset. Establishing a CAB and truly collaborative processes are key for fostering shared ownership and promoting longer term treatment sustainability.